Peira Nathalie, Ali Elham Mohammed, Modén Naama Kenan, Fjellgren Eva, Lennmarken Claes, Hultcrantz Monica
HTA Region Stockholm, Center for Health Economics, Informatics and Health Care Research (CHIS) Stockholm Health Care Services, Stockholm, Sweden.
Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Acta Ophthalmol. 2025 Jun;103(4):371-379. doi: 10.1111/aos.16802. Epub 2024 Nov 29.
Dry eye disease is a common ocular condition, affecting quality of life and function for many people worldwide. This systematic review evaluates the effectiveness and safety of intense pulsed light (IPL) therapy for dry eye symptoms due to meibomian gland dysfunction (MGD), as they are not yet established.
Comprehensive searches were conducted in January 2024 (Cochrane Library, Embase, MEDLINE). We included randomized controlled studies assessing the effects of IPL on dry eye symptoms or any adverse effects in patients with MGD. Two authors independently screened studies and evaluated the risk of bias. Meta-analysis (random effects model) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to synthesize results and assess certainty of evidence.
In total, 13 studies were included in the review. The risk of bias was assessed as moderate in most results primarily due to the risk of selective reporting. The synthesis and GRADE assessment show that IPL probably results in a clinically relevant reduction in symptoms of dry eyes when compared to placebo (MD = -16 OSDI points; 95% CI = -20 to -12). However, whether the effect is clinically relevant when used as an add-on to standard care is still unclear (MD = -7 OSDI points; 95% CI = -12 to -3). Furthermore, the evidence on adverse events is very uncertain.
Although IPL probably results in a clinically relevant reduction in symptoms of dry eyes when compared to placebo, in practice IPL would typically be used as an add-on to standard treatment. It is therefore essential with further studies investigating whether this use would give a clinically relevant reduction in symptoms, and what the potential harm of IPL is when treating MGD.
干眼症是一种常见的眼部疾病，影响着全球许多人的生活质量和功能。本系统评价评估强脉冲光（IPL）治疗睑板腺功能障碍（MGD）所致干眼症状的有效性和安全性，因为目前尚未明确。
于2024年1月进行全面检索（Cochrane图书馆、Embase、MEDLINE）。我们纳入了评估IPL对MGD患者干眼症状或任何不良反应影响的随机对照研究。两位作者独立筛选研究并评估偏倚风险。采用Meta分析（随机效应模型）和推荐分级评估、制定与评价（GRADE）来综合结果并评估证据的确定性。
本评价共纳入13项研究。大多数结果中的偏倚风险被评估为中等，主要原因是存在选择性报告的风险。综合分析和GRADE评估表明，与安慰剂相比，IPL可能会使干眼症状在临床上有显著减轻（MD = -16 OSDI分；95%CI = -20至-12）。然而，当作为标准治疗的附加治疗时，其效果在临床上是否显著仍不清楚（MD = -7 OSDI分；95%CI = -12至-3）。此外，关于不良事件的证据非常不确定。
虽然与安慰剂相比，IPL可能会使干眼症状在临床上有显著减轻，但在实际应用中，IPL通常会作为标准治疗的附加治疗。因此，有必要进一步研究这种应用是否会在临床上显著减轻症状，以及IPL治疗MGD时的潜在危害是什么。
